a medical librarian's adventures in evidence-based living

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July 2009

July 24, 2009

"We can’t change the world except insofar as we change the way we look at the world — and, in fact, any one of us can make that change, in any direction, at any moment."

Pico Iyer, writer-journalist who has covered the Dalai Lama for 35 years

It's been a busy week, and I probably won't have much time to write over the coming week.

Thinking about all that I have read this week, it dawned on me that all the advice anyone could ever need for a Happy Healthy Long Life appeared in 2 newspaper articles, 1 blog post, and 2 medical journal articles just this week!

The only advice you'll ever need (I always exaggerate):

1. You make your own happiness. It's not about money. Stop blaming others, let go of your illusions & expectations and work on yourself.

2. Lower your expectations for happiness & you won't be disappointed.

3. Unclutter your life--in terms of stuff, people & activities--determine what and who matters most.

“We can’t change the world except insofar as we change the way we look at the world — and, in fact, any one of us can make that change, in any direction, at any moment. The point of life, in the view of the Dalai Lama, is happiness, and that lies within our grasp, our untapped potential, with every breath.”

“Easy for him to say, you might scoff. He’s a monk, he meditates for four hours as soon as he wakes up and he’s believed by his flock to be an incarnation of a god.”

But, don't be so quick to judge. Believe me, his life has been filled with challenges & responsibilities that would send most of us running & screaming for cover.

“Yet in 35 years of talking to the Dalai Lama, and covering him everywhere from Zurich to Hiroshima, as a non-Buddhist, skeptical journalist, I’ve found him to be as deeply confident, and therefore sunny, as anyone I’ve met.”

He’s a realist and he’s practical, with optimism & a sunny nature. Which is exactly why people all over the world want to know---How can I be like that?What the Dalai Lama would advise:

1. If an arrow is sticking out of your side don’t argue about where it came from or who made it; just pull it out. You make your way to happiness not by fretting about it or trafficking in New Age affirmations, but simply by finding the cause of your suffering, and then attending to it, as any doctor (of mind or body) might do.

2. Think in terms of enemies, he suggests, and the only loser is yourself.

3. Concentrate on external wealth and at some point you realize it has limits — and you’re still feeling discontented.

4. Learn how to be delighted by the smallest birthday cake.

5. Happiness is not pleasure, and unhappiness, is not the same as suffering. Suffering — in the sense of old age, sickness and death — is the law of life; unhappiness is just the position we choose — or can not choose — to bring to it.

6. How can you always remain so happy and smiling?” That kind of happiness is within the reach of almost anyone.

7. We can work on happiness as we work on our backhands, our soufflés or our muscles in the gym.

True happiness, in that sense, doesn’t mean trying to acquire things, so much as letting go of things (our illusions and attachments). It’s only the clouds of short-sightedness or ignorance, that prevent us from seeing that our essential nature, is blue sky.

Why Is Denmark the Happiest Country in the World? Lowered Expectations!

Denmark is the happiest nation in the world.Why? Low expectations. And that’s one of the big secrets of happiness.

“We’re the happiest lige nu.” Lige nu is a Danish phrase that means literally “just now” but strongly connotes a sense of “for the time being but probably not for long.”

Danes, in other words, harbor low expectations about everything, including their own happiness.

Danes seem to know instinctively that expectations kill happiness, leaving the rest of us unhappy un-Danes to sweat it out on the “hedonic treadmill.”

That’s what researchers call the tendency to constantly ratchet up our expectations, a sort of emotional inflation that devalues today’s accomplishments and robs us of all but the most fleeting contentment.

If a B-plus grade made us happy last semester, it’ll take an A-minus to register the same satisfaction this semester, and so on until eventually, inevitably, we fail to reach the next bar and slip into despair.

Yes, happiness is a function of our expectations — or, as it has been said: “Happiness equals reality minus expectations.”

Given that neat formulation, there are two ways to attack the problem: boost our reality or lower our expectations. Most of us choose the former. We’d rather stew in our misery than trim our expectations. Lowering our sights smacks us as a cop out, un-American. Better a nation of morose overachievers, we reason, than a land of happy slackers.

Erin Doland, The Unclutterer, Shares Her Advice on "Having It All" and Remaining Sane

How do you have time for all of this - running a blog, writing a book, all of these musical activities & all the other stuff you seem to do?

1. Purge clutter, downsize, and minimize. The less stuff you own, the less you have to clean, store, maintain, manage, protect, worry about, stress about, waste money on, forget, and pick up. Have the minimum amount of stuff for you to be comfortable. (This level is different for everyone and you’ll have to figure it out for yourself.)

2. Organize what you choose to own and use. Your home and office don’t need to be pristine museums, but you and the people who access the same space/items need to be able to easily find things when they’re needed. Order is better than chaos, and order saves you time and energy.

3. Commit to a streamlined routine for the mundane tasks in your life and be disciplined enough to maintain that routine. If you do 30 minutes of housework a day, your home is never chaotic. But, you have to be committed to these daily activities (dishes, laundry as needed, things put back in place when finished, kitty litter scooped, etc.) and not put them off for another day. The same is true for work; you have to stay on top of the necessary tasks or they will haunt you. I also think of this item as taking responsibility for the things you choose to own.

4. Determine what matters most to you. Make a list of the people, activities, and things in your life that mean the most to you and then spend the vast majority of your time focusing on these items. Be honest with yourself, though, and put on your list what really matters to you, not what you think should matter to you.

5. Remind yourself that even if you live to be 100, life is short. There is no better time to live your life than right now. My life’s motto is carpe vitam, Latin for seize life. It’s morbid to think about, but someday might not ever come. Stop putting things off until tomorrow. 6. Say “no” to what doesn’t matter. If an activity or responsibility isn’t on your list of what matters most to you, say “no” to it. Learn to say “no” in such a way as to not be a jerk, but say “no” when you need to. This is where I greatly differ from most people because I don’t feel guilty about protecting my time. And, as far as I know, most people don’t think I’m a jerk because I’m clear about why I’m declining offers and invitations. (”Taking a yoga class with you would be fun, but Wednesday nights are date night with my husband. Is there a similar class we can take together on another night?”) 7. Enjoy being industrious. Working provides us with the resources to take care of the things that matter most. Whatever you do for a career, make sure it is something that you enjoy (even if just minimally). 8. Get rid of everything that is toxic in your life because toxic things are clutter. Toxic people and habits suck up resources and energy. I was an avid smoker until I calculated how much of my money, time, and energy were going into my smoking addiction. No matter how gifted and talented, I avoid employing, working with, and spending time with people who are toxic. A toxic person can waste your time and mental energy faster than any other form of clutter.

9. Live within your means and save money for retirement, rainy days, and adventures. Get rid of your credit cards and only use cash or your debit card. Live on a budget even if you don’t need to be mindful of your spending habits. Have a retirement account, and two savings accounts — one for emergencies (refrigerator died, fender bender) and one for splurging on what matters most to you (vacation, rock climbing lessons, a camera to capture your child’s first steps). Buy quality instead of quantity. Be a smart consumer.

10. Take risks and be brazen. A second motto in my life is ad astra per aspera, which is loosely translated as to the stars through difficulty. (It’s also the Kansas state motto.) Great things might fall in your lap from time to time, but for the most part you have to get outside your comfort zone and initiate something new. Have you always wanted to learn to play the flute? Get your hands on a flute and start taking lessons. You’ll be really awful those first six months (or year or five), but you’ll never learn to play the flute if you don’t take the chance and try.

11. Get adequate sleep. Keep a sleep journal and find out how much sleep you need to function at your best. Then, make sure you get that amount of sleep every night. When you’re well rested, it’s easier to stay calm, be productive, and focus on what you need and want to do.

From JAMA: The Physicians' & Nurses' Health Study: The Six Behaviors for a Long Healthy Life

The Six Healthy Behaviors:

1. Control your weight. Stay trim. A BMI under 252. Exercise vigorously for 30 minutes a day.3. No smoking4. Eat a diet in line with the DASH Diet--lots of vegetables, fruit, and whole grains (especially for breakfast)--and be sure to get 400 mcg of folic acid/a day.5. Moderate to low alcohol consumption6. Keep non-narcotic pain relievers down to less than once a week.

All that heart-healthy advice about eating the right foods, exercising and losing weight pay off in real life for both men and women, two new studies show.

The reports, both originating at Brigham and Women's Hospital in Boston and published in the July 22/29 issue of the Journal of the American Medical Association, focused on different aspects of cardiovascular risk in two large groups: the 83,882 women in the second Nurses' Health Study, and the 20,900 men in the Physicians' Health Study I.

Both arrived at the same conclusion: Do the right things, and you get measurable benefits.

Simultaneous appearance of the two reports was more or less a coincidence, said Dr. Luc Djousse, an associate epidemiologist at Brigham and Women's at Harvard Medical School, who led the men's study.

While the clear message of both studies is that "a healthy lifestyle prevents a number of illnesses," what is often overlooked is that the choice of a healthy lifestyle is not a purely individual decision, said Dr. Veronique L. Roger, a professor of medicine and epidemiology at the Mayo Clinic, who wrote an accompanying editorial.

"There is a shared responsibility between the individual and the community," said Roger, who read off a dictionary definition of lifestyle as "a typical way of life of an individual, group or culture."

"The reality is that society has engineered physical activity out of our lives," Roger said. "

"SUMMER may not be the best time to cook, but it’s certainly among the
best times to eat. Toss watermelon and peaches with some ingredients
you have lying around already, and you can produce a salad that’s
delicious, unusual, fast and perfectly seasonal.

That’s the idea behind the 101
ideas found in this section. In theory, each salad takes 20 minutes or
less. Honestly, some may take you a little longer. But most minimize
work at the stove and capitalize on the season, when tomatoes, eggplant, herbs, fruit, greens and more are plentiful and excellent.

This
last point is important. Not everything needs to be farmers’ market
quality, but it’s not too much to expect ripe fruit, fragrant herbs and
juicy greens.

Salt, to taste, is a given in all of these recipes. Pepper, too (if I want you to use a lot of pepper, I say so).

Herein, then, are enough salad ideas to tide you over until the weather cools down."

Here are just a few that I can't wait to try:

1. Cube watermelon and combine with tomato chunks, basil and basic
vinaigrette. You can substitute peach for the watermelon or the tomato
(but not both, O.K.?). You can also add bacon or feta, but there goes
the vegan-ness.

Note: I like Mark's blender salad dressing suggestions, but I'll be cutting way down on the oil, upping the vinegar or adding lemon, lime or orange juice to make up for the liquid. Dr. Joel Fuhrman advises subbing 2 tbs. of nut butter or tahini for the oil. Usually just a tablespoon of dressing is more than enough.

Be sure to click on the actual article & don't miss all the salad dressing recipes in the sidebar!

I couldn't make it to the free screening of Food, Inc. when it first came to town--I had to go to an event that served barbecued ribs & chicken. (oh my!) I passed my tickets on to Fran & Joyce.

They went into this well-done documentary not knowing what to expect--and came out shocked, a little queasy, concerned, disturbed, with their heads spinning and ready to rethink meat.

But this movie is not about the evils of beef, chicken or pork! In fact--grass-fed, pasture-raised, small-farm-raised would be just fine. It's about how our whole food industry has changed for the worse since 1970--and No One Is Paying Attention.

I finally got to see the film on Sunday. That night I called my kids & said, "You have to go see this movie!"

The film's promo says it all:

How Much Do We Really Know About The Food We Buy At Our Local Supermarket & Serve To Our Families?

You'll Never Look At Dinner The Same Way

In Food, Inc.,
filmmaker Robert Kenner lifts the veil on our nation's food industry,
exposing the highly mechanized underbelly that has been hidden from the
American consumer with the consent of our government's regulatory
agencies, USDA and FDA.

Our nation's food supply is now controlled by a
handful of corporations that often put profit ahead of consumer health,
the livelihood of the American farmer, the safety of workers and our
own environment.

We have bigger-breasted chickens, the perfect pork
chop, herbicide-resistant soybean seeds, even tomatoes that won't go
bad, but we also have new strains of E. coli—the harmful bacteria that
causes illness for an estimated 73,000 Americans annually.

We are
riddled with widespread obesity, particularly among children, and an
epidemic level of diabetes among adults.

Featuring interviews with such experts as Eric Schlosser (Fast Food Nation), Michael Pollan (The Omnivore's Dilemma, In Defense of Food: An Eater's Manifesto) along with forward thinking social entrepreneurs like Stonyfield's Gary Hirshberg and Polyface Farms' Joel Salatin, Food, Inc.
reveals surprising—and often shocking truths—about what we eat, how
it's produced, who we have become as a nation and where we are going
from here.

David Edelstein of New York Magazine Says It Best

David's experience echoes mine 100%. Do No Miss This Movie!

"After an hour and a half of sighing, wincing, and clucking over the manifold outrages portrayed in Robert Kenner’s Food, Inc.,
I gave up the thought of “reviewing” the documentary and decided,
instead, to exhort you:

See it. Bring your kids if you have them. Bring
someone else’s kids if you don’t.

The message is nothing new if you’ve
read Eric Schlosser’s Fast Food Nation or Michael Pollan’s The Omnivore’s Dilemma
(both are in the film). But every frame makes you choke on your
popcorn—if for no other reason than the focus on
government-underwritten corn and the companies who put it into
everything from soda to Midol to the gassy, E. coli–ridden
bellies of factory-farmed cows.

The sheer scale of the movie is
mind-blowing—it touches on every aspect of modern life. It’s the
documentary equivalent of The Matrix: It shows us how we’re
living in a simulacrum (a sham--a vague likeness), fed by machines run by larger machines with
names like Monsanto, Perdue, Tyson, and the handful of other
corporations that make everything.

We humans can win, but we
should hurry, before Monsanto makes a time machine and sends back a
Terminator to get rid of Schlosser and Pollan."
— David Edelstein

A Snapshot of the Images I Will Never Forget

The giant dark filthy foul-smelling football-field-sized chicken houses filled with 40,000 or more birds pumped up with pharmaceuticals, standing in excrement, with bodies grown unnaturally fast, and breasts so large their tiny legs can barely hold them up.

Cattle living in giant feeding lots, packed in head to rump, pumped up with antibiotics to kill the diseases caused by being unnaturally force fed corn when they're meant to graze on grass in open fields. Meat carcasses coated with excrement that could never be sanitized enough to kill the germs they might harbor. Oh--but don't worry--now there's a company that washes hamburger with ammonium hydroxide to kill the buggers--Beef Products, Inc. (BPI)--winner of the 2004 Food Quality Award.

The abused illegal immigrants working in deplorable dangerous meat packing plants--a new class of indentured servants--that have no choice but to keep silent about what's going on at their workplace--or risk deportation. No need to worry about unions.

The family farmers that are no more. They are essentially factory workers, the new indentured servants, working for the 4 or 5 beef, poultry or pork industrial producers. Borrowed to the hilt, to the tune of $500,000 on average, and making about $18,000 a year.

The low-income families that find it more affordable to feed their families for $15.00 at McDonald's, than to buy broccoli and apples. Result: epidemic obesity & type-2 diabetes, even in kids. Saving money on food, but making it up in health care costs.

The healthy 2 1/2 year old who died suddenly after eating an E coli-tainted hamburger while on a family vacation. The meat could have been recalled. It wasn't.

The number of food industry execs and lawyers who end up serving in high government offices in the Department of Agriculture, the Food & Drug Administration, and the Supreme Court (Clarence Thomas-for instance). We don't stand a chance.

Just see the movie!!

Check out the Food, Inc. website and you'll be Hungry for a Change. Click here.Priceless quote from Mr. Richard Lobb of the National Chicken Council:

"What these systems of intensive production accomplish is to produce a lot of food on a small amount of land at a very affordable price. Now somebody explain to me what's wrong with that!"

Joel Salatin, organic farmer, owner of Polyface Farms in Virginia:

"When you add up the environmental costs, recycle costs, health care costs, the industrial food is not honest food. It's not priced honestly. It's not produced honestly. There's nothing honest about that food."

The controversial conclusion: The researchers say that now, 20 years after the experiment began, the monkeys are showing many beneficial signs of caloric restriction, including significantly less diabetes, cancer, heart and brain disease. In principle, people could fend off the usual diseases of old age and considerably extend their life span by following a specialdiet.

What is "Real Man" #1 Roger Cohen of the New York Times Saying about Cheeseburgers?

Roger: "Why would anyone want to extend his life if it meant giving up cheeseburgers & fries? Why inflict needless misery on yourself?" Read his opinion piece here. (I say, "Why would anyone want to risk an old age filled with disability just for the sake of eating cheeseburgers & fries?)

Well-fed Owen, by contrast, is a happy camper with a wry smile, every inch the laid-back simian, plump, eyes twinkling, full mouth relaxed, skin glowing, exuding wisdom as if he’s just read Kierkegaard and concluded that “Life must be lived forward, but can only be understood backward.”

It’s the difference between the guy who got the marbleized rib-eye and the guy who got the oh-so-lean filet. Or between the guy who got a Château Grand Pontet St. Emilion with his brie and the guy who got water.

Maybe Roger doesn't know anyone who suffered a massive stroke because of atherosclerosis, and endured 16 years without being able to walk or talk. Maybe he hasn't seen someone whose life is cut short or severely restricted because of diabetes, heart disease, or vascular dementia. The list goes on.

Eating plant-based, vegan, nutritarian, or whatever you want to call it, isn't caloric restriction (eating 30% less calories a day) but it still is restriction of sorts--and it's definitely a change. No meat, no dairy, no chicken, no processed foods. But it certainly isn't deprivation. My eating repertoire has mushroomed way beyond cheeseburgers & fries.

Two Emails - Two Completely Different Points of View

Roger Cohen's flippant opinion piece made me think about the two emails I received recently.

One came from Michael F., who decided he was tired of being overweight and unhealthy and decided to do something about it.

The other came from Leonard J., who after having major heart surgery, thought about changing his diet, and decided, "Nope, don't think so! Life without cheeseburgers and fries just isn't worth it."

The following came from an email I received from one of my readers, Michael F. (*I added the headers)

Dear Healthy Librarian,

I'd like to share with you my own success story following a plant-based diet. I think Dr. David Kessler's new book, The End of Overeating is absolutely right on the money.

"The China Study" & Dr. Fuhrman's "Eat to Live"Principles. Since the beginning of last November I've lost 107 lbs through following essentially the spirit of The China Study and really to the letter of Dr Fuhrman's writings.

The addictive power of fat, sugar, & salt. I was and will continue to be successful this time because I approached it as an addiction. Explicitly, I knew I would have to eat to accelerate withdrawal, break addictions, and re-boot my mental and physical chemistry. It took around 4 to 6 weeks.

Keep Junk Food Out of the House. To be safe and get through as quickly as possible, my wife and I agreed to a few specifics. First, we purged the house of anything not allowed; if it had been there, I would have found it and eaten it. Second, we agreed to not eat out at restaurants until I was ready.

Curb the Restaurant Habit First. I didn't eat out at a restaurant for two and half months. The first time I actually "ate out" was when we were driving to a concert and stopped at roadside fruit stand and we bought a banana, an apple and some citrus. I hadn't had a banana for months, even though they are fruit, merely because of the sugar content. I couldn't believe my reaction when I took my first bite. It was like eating a piece of massively overly rich cake some crazy aunt had foisted upon you during a holiday family gathering. I was stunned. It was so rich tasting it was sickening. Thinking I had got a bad banana I had my wife try it and she said, "Nope. It's just a normal banana." It was surreal. I couldn't believe what they books had said would happen had really happened.

Changing Your Food Tastes & Cravings. After this I had re-trained my tastes to desire the healthy things I was eating. It took a little more than two months until I noticed one day I no longer had to grab the remote and change the station away from pizza commercials in fear of the stimulus-response.

Avoiding Usual Food Traps & Falling Back Into Bad Habits. During the first few months it was exactly like quitting smoking. To break the late night habit of drive through at In & Out Burger, I changed into sleeping clothes early and read or watched TV in bed. I made up an extensive menu of meals I enjoyed where I could eat all I wanted (of vegetables, beans, and fruits) to attain a sense of fullness. I shopped daily at Trader Joe's for freshness.

Cutting Caffeine, Sugar, Salt, Fat, and White Flour. I cut green tea which stopped the caffeine from spiking hunger. I have no sugar, salt, flour, wheat, or oil. I don't count calories. I eat when hungry but try to make time to eat three well spaced meals. I work out once if not twice a day.

Easing Back Into the Restaurant Scene. Eventually, my wife and I began going to restaurants again (lots of time I would eat before-hand or afterward). Up until then, I had spent 39 years wherein when I saw or smelled delicious food I immediately wanted to eat it. Now, it was again bizarre. It was as if someone had severed the nerve connection between smell and aesthetic looks and the need to taste. I couldn't believe it. It looked good but I didn't want to eat it.

Going Through Food Rehab. When my wife and I were watching a recent Oprah she had on a few celebs and others who had lost and then regained tremendous weight. They all seemed to frame it as a battle of mental will and discipline. It was perfectly clear to me why they and all others who regain lost weight do so: they haven't gone through what Terry Gross calls "Food Rehab" in her interview with David Kessler.

GROSS:So what are some of your suggestions for effective food rehab?

Dr. KESSLER: There are things I can do just to decrease the amount of stimulation. So don't cue me. You know, take that bread away. I don't want to see that because that's only going to increase the stimulation. Or don't deprive me because if - deprivation's only going to increase the reward value. So taking away the cues, not being primed, decreasing feelings of deprivation, all those can decrease being stimulated. But how realistic is that in our current environment? So, you know, the ultimate goal is to cool down the stimulus. And the way to do that is to want something more. So I can set rules for myself. I can eat in not a chaotic way and say boy, I don't want this now, I'm going to want something better later. So rules work. Structured eating, eating in - in meals. But ultimately is to have what psychologists call a critical perceptual shift. If you look at a huge plate of fries and say wow, that's great. But if you can get to the point of looking at those - that food, that plate of nachos and say boy, what is that? That's just fat on fat on sugar and fat. If you can change what, you know, what scientists call the reward value of the stimulus, then when you are cued by that stimulus, your brain doesn't get stimulated, you don't get activated.

It's Not About Discipline or Willpower--Surround Yourself with Healthy Options--Taste Preferences Can Change. I am convinced that the "key" (if there is one, sorry to be dramatically reductionistic) is to change the physical to control the mental. Friends and loved ones cannot believe I happily survive on either steamed/raw vegetables, beans, fruit, nuts/seeds. They say "you are so disciplined, I could never do that." Actually, at this point there is no discipline. The only remaining challenge is to be tolerant of the waiting for the rest of the weight to melt.

Conquer Food Addiction First. Mental discipline is no match for physical craving. I am convinced that someone ought to write a book addressing purely the "how to" of weight loss around the thesis of addiction. Change the body and the mind will follow.

I had the good fortune to have my heart attack while in the cafeteria at Tripler Army Hospital for another appointment. My wife quickly found a Doctor in the dining room and I was taken in a wheelchair to have tests done. The test results indicated I needed surgery. They did 5 bypasses and the surgery had some bad problems with bleeding and I was in there for 13 hours.

I remember seeing a Colonel later on. He told me, "I can't believe you're alive." His people did a great job.Prior to the surgery, I had received an email from the son of a classmate. He told me that his mom had died after refusing to do a surgical procedure on her heart. For some reason it was the first thing I thought of when I regained consciousness in recovery. I immediately thought, "Beverly was right." After a few weeks at home I no longer felt that way, of course.

What I am writing about is the approach people take after surgery.Initially I was going to change my diet and do all the "right things."

Eventually I realized I won't be around forever and was already 70, so I decided to enjoy my bacon and eggs and all those things I was denying myself. I won't gain a few months of life through boring behavior, but I will enjoy every waking minute I have left.

Now 73, the only thing that keeps me from doing more, is the lack of energy I once had. I am leaving in another hour or so for a cold beer and great cheeseburger by the ocean in Waikiki.

Aloha, LeonardIn A Later Email, Leonard Wrote Back To Explain Further:

Dear Healthy Librarian,

I am aware of all the possible risks to having heart disease, having been a Type 1 diabetic since 1967 (at age 31). Didn't ever think I would still be around now.

I'm not worried about having a stoke and dealing with that sort of long-term disability. I take three different meds for blood pressure which work well. It was 94 over 46 a few minutes ago. It makes one a little dizzy, but I really prefer it this way. No one has ever had a stroke in our family, but heart attacks are the norm. I hope I can die in my sleep as my mom did.

Good luck with your health. I find it hard to believe that it is 2009 and we can't come up with a pill that dissolves plaque. Oh well, I have been fortunate to say the least...

Steve McKee's story strikes so close to home for me. My dad suffered a massive stroke at age 69 that left him alive, but unable to talk, read or communicate for 16 years. What saddens me the most is that he never had the chance to really know his grandchildren.

My dad never went to a doctor until after it was too late. He never knew he had high blood pressure or high cholesterol, or that he was considered obese by today's standards. He's the reason I started exercising and eating right over 30 years ago. Steve's story makes me glad I did!

Yes, I loved cheeseburgers & fries. But I'd prefer to stay healthy for as long as I can. Besides, I've really grown fond of Boca & Dr. Praeger's Burgers.

I promise, this is my last post about Field Roast Vegan Sausages! Read my review + recipe here. I had the Apple Sage variety in the freezer & was wondering what the heck to do with them. Then it dawned on me, "They'd go great with Jeanne Lemlin's fruit & nut rice salad!"

This salad is amazing on its own--it's got "Big Taste". It's one of my favorites to take to potlucks or to make for company---even my "super picky" niece Anna gave it a big thumbs up when she had it at my NYC son's apartment.

Add the smoked apple sage "grain meat" sausages, made with Yukon Gold potatoes, apples & rubbed sage into the mix and you have yourself "One Amazing Main Course"--fit for company. Just wait until you read the crazy mishmash of tasty ingredients that go into this dish.

Fair warning: This isn't a last minute quickie, but if you prep all the ingredients while the rice cooks it will take about 1 hour from start to finish.

1. In a medium-size saucepan over high heat combine the water, salt, olive oil, wild rice, and brown rice. Cover the pan and bring to a boil. Reduce the heat to a simmer and cook 30 minutes.

2. Remove the cover and sprinkle in the jasmine or basmati rice, being careful not to disturb the rice below. Cover the pan and cook about 20 minutes, or until all the water has been absorbed and the rice is just about to start sticking to the pot.

3. Meanwhile combine the dried cranberries, currants, and apricots in a large serving bowl. When the rice is cooked, carefully spoon it onto the dried fruit and toss just enough to incorporate it without making it gummy, a few strokes. Let the mixture cool completely--the heat from the rice will plump up the dried fruit.

5. Make the dressing. Combine the lemon juice with 1/4 cup of the tofu & mix until smooth in a blender. Combine the lemon emulsion with the garlic, shallots, salt, pepper, and olive oil in a small bowl & whisk together.

5. Gently stir the pecans, scallions, parsley, mint, basil, and sausage slices into the rice mixture. Pour on the dressing and toss. Chill and let marinte a few hours before serving. We ate this right away--couldn't wait for the marinating--and it was just fine! Serve at room temperature.

Serves 6

NOTES: This is company fare. Definitely not low-fat or low-salt. Not Esselstyn-approved. But soooo good. And Field Roast products are made with vital wheat gluten (seitan)--so those with gluten allergies--STAY AWAY!

**An interested reader who is sensitive to MSG (it can be a migraine trigger) wondered about Field Roast's use of "naturally flavored yeast extract" --was it a masquerade for MSG. She wrote to the company & got this reply in short order:

Hello!

Thanks for getting in touch with us regarding your concerns about Yeast Extracts and MSG. At Field Roast, we use yeast extracts because they provide an excellent savory foundation to our foods. They are certainly high in glutamates; a naturally occurring amino acid found in many natural foods including mushrooms, tomatoes and parmesan cheese. This makes our food even more delicious.Our intention is to make a delicious food that nourishes, not hurts people. If glutamates (and other forms of glutamates) cause you migraines, I think the right move for you would be to not eat our foods.

Thank you so much for reaching out to us- have a wonderful day!Kindest Regards,Cindi-- Cindi HellumsThe Field Roast Grain Meat Company1440 South Jackson StreetSeattle, WA 981441-800-311-9497206-762-5961www.fieldroast.com

July 15, 2009

"We still need to believe in something that will give us our vital daily dose of meaning and motivation. As we grapple with the complexities of our age, I suggest that we agree on one principle: that a crucial measure of our success in life is the way we treat one another every day of our lives....Good relationships make our lives good; bad relationships make our lives bad. We are usually happy (or unhappy) with others."

1. Last week's staff meeting left me feeling vaguely uncomfortable & uneasy. A colleague threw out a general plea to the more senior staff for some sage advice and an experienced critique of her new project.

Instead of enthusiasm, encouragement, and offers of one-on-one help, she got unintentional-yet-dismissive advice, "Go online and take a look at how it's done." "There are on-line books and manuals to teach you how to do that." Right! Thanks, a lot! Just what you want to hear, "Read the manual."

2. Right after work I happened to read the Most Popular E-Mailed Article in the New York Times for the day: David Brooks', In Search of Dignity. Brooks' subject is about the downward drift of dignity in today's politicians & celebrities--the Mark Sanfords, Sarah Palins, & Michael Jacksons--and yes, all the rest of us.

Civility has hit the skids. Manners and morals are history. And it's all about ME these days.

Brooks holds George Washington up as our civility maven--our country's standard bearer. You see, George methodically worked on making himself a better person. Trust me--this is no small feat.

"When George Washington was a young man, he copied
out a list of 110 “Rules of Civility and Decent Behavior in Company and
Conversation.” ( Click here for a look at George Washington's 110 Rules of Civility & Decent Behavior.) Some of the rules in his list dealt with the niceties of
going to a dinner party or meeting somebody on the street.

They were designed to improve inner morals by shaping the outward man.
Washington took them very seriously. He worked hard to follow them. Throughout his life, he remained acutely conscious of his own rectitude. In so doing, he turned himself into a new kind of hero.

But the dignity code itself has been completely obliterated. The rules
that guided Washington and generations of people after him are simply
gone.

We are all encouraged to become managers of our own brand, to do
self-promoting end zone dances to broadcast our own talents. Second,
there is the cult of naturalism. We are all encouraged to discard
artifice and repression and to instead liberate our own feelings."

-David Brooks-

Who doesn't need a kick in the pants to remind us about the simple rules of civility that have been around in one form or another for thousands of years, appearing in the texts of all religions, from Judaism and Christianity to Confucianism and Hinduism, from Victorian books of manners, to philosophers from Plato to Kant? Goodness knows, I do!

But wait--P.M. Forni, started the Johns Hopkins Civility Project back in 1997 & he has made it his personal mission to compile a quintessential readable rulebook on being nice without being a doormat.

I adored this book when I first read it seven years ago, and I'm still a fan now that I've rediscovered it tucked away on my book shelf--thanks to getting a kick in the pants from David Brooks last week.

P. M. Forni's wise-slim-witty-practical book, Choosing Civility came out in 2002. It was adopted by cities, and schools & organizations. But I haven't heard much about it lately. That's too bad, because it's a gem--worth dipping back into often.

This book isn't sugar-coated fluff. It's practical advice for just plain improving our day-to-day contact with everyone we encounter at work, at home & in our daily lives--including everyone that makes us want to scream or tear our hair out--like inconsiderate drivers, obnoxious loudmouths, and rude sales clerks.

So, here's the Cliff's Notes version. The bare bones. The book is so much better!

The Twenty-Five Rules of Considerate Conduct

1. Pay Attention

"A human moment occurs anytime two or more people are together, paying attention to one another." -Edward M. Hallowell-

"Every act of kindness is, first of all, an act of attention. We may see a coworker in need of a word of encouragement, but it is only if we pay attention that we may do something about it." -P.M. Forni-

"A car in trying to join the traffic flow from the parking lot to my right. Since the traffic is bumper-to-bumper, if everybody thinks of that car as just another car, its driver will be stuck forever. I slow down to let him in ahead of me." -P.M. Forni-

2. Acknowledge Others

"Every action done in company, ought to be with some sign of respect to those that are present." -George Washington-

"Acknowledge others' existence, their importance to you, their feelings, and the things they do for you. Remembering someone's name--paying a thoughtful compliment--just saying hello..." -P.M. Forni-

3. Think the Best

"There is no doubt that thinking the best of others can boost the quality of your life. Among other things, it will help you establish rapport with many people who otherwise would remain strangers." -P.M. Forni-

"Look for the best in everybody. If you wait long enough, people will surprise & impress you." -Randy Pausch-

4. Listen

"Much of the conflict in our lives can be explained by one simple but unhappy fact: We don't really listen to each other." -Michael P. Nichols-

"What prevents us from doing a good job of listening is that instead of focusing on other people, we focus on ourselves and our needs. This is what we do, for instance, when we interrupt." -P.M. Forni-

5. Be Inclusive

"The great secret, Eliza, is not having bad manners or good manners or any other particular sort of manners, but having the same manners for all human souls: in short, behaving as if you were in heaven, where there is no third-class carriages, and one soul is as good as another." -George Bernard Shaw-

"Try speaking and listening to somebody you never liked." -P.M. Forni-

"One of our strongest yearnings is to be accepted by others. We love being welcomed by individuals, and we delight in the feeling of belonging to a group. Thus attitudes and words that exclude rather than include are rarely funny. In most cases they hurt." -P.M. Forni-

6. Speak Kindly

"A word of kindness is seldom spoken in vain, while witty sayings are as easily lost as the pearls slipping from a broken string." -George Prentice-

"Speaking
with consideration and kindness is at the heart of civil behavior. To
speak kindly you need to be aware constantly that you are speaking to
living, breathing, vulnerable human beings." -P.M. Forni-

"Don't discount the power of your words. The thought that they
might hurt or discomfort should inform every conversation. By speaking
with kindness you improve the lives of those around you." -P.M.
Forni-

"By and large, the first, the important, the defining thing we want to know about our fellow humans is whether they are nice." -P.M. Forni-

8. Accept and Give Praise

"The deepest principle in human nature is the craving to be appreciated." -William James-

"By saying, "What you are doing is wonderful," we encourage those who are doing the wonderful thing to keep doing it. Maybe in a small way, we become responsible for the continued existence of something wonderful." -P.M. Forni-

9. Respect Even a Subtle "No"

"The stranger sitting beside you on the plane is paying more attention to his or her laptop than your attempts to start a conversation--that's a No." -P.M. Forni-

"We frequently fail to understand or choose to ignore signs of reluctance in others. When that happens, we end up making others do what they would rather not or we force them to flat out say, "No," upsetting them in the process. This is not civil." -P.M. Forni-

10. Respect Others' Opinions

"Among the most civil utterances of all time is the simple, humble, and smart question, "What do you think?" Let's use it generously." -P.M. Forni-

"There are at least two ways of showing disrespect for others on account of what they think. One is by telling them that their opinions are crazy, stupid, worthless, and the like. The other is by assuming that what we think must be what they think also." -P.M. Forni-

11. Mind Your Body

"The idea is to attract, not repel." -Peggy & Peter Post-

12. Be Agreeable

There are two fundamental abilities to cultivate in order to be agreeable in conversation:

The ability to consider that you might be wrong.

The ability to admit that you don't know. -P.M.Forni-

13. Keep It Down (and Rediscover Silence)

"Many people believe that constant noise is normal" -Judith Martin-

14. Respect Other People's Time

Punctuality is non-negotiable! -P.M. Forni-

"Call waiting titillates the basest of impulses--greed and opportunism. It plays on our anxiety--the nasty little need to know what or who might be better than what we've got now." -Lynne Sharon Schwartz-

15. Respect Other People's Space

"Come not near the books or writing (or computer screen) of another so as to read them unless desired; also look not nigh when another is writing a letter (or an email)." -George Washington-

16. Apologize Earnestly

"Most apologies are gestures of empathy; they express regret for offending someone else's feelings or concerns. Apologizing implies that you are aware of the feelings of another and can empathize sufficiently to regret have injured that person." -Daniel Jankelovich-

"Apologizing is a decent thing to do, but it is not true that the more we do it the better human beings we are. As we become more aware of the needs of others and more willing to honor them, we find ourselves apologizing less frequently." -P.M. Forni-

17. Assert Yourself

"Wanting to please others is a noble sentiment at the root of civility and an indispensable ingredient in happy relationships. However, just as crucial for our happiness is the ability to establish firm personal boundaries." -P.M. Forni-

18. Avoid Personal Questions

"Taboo questions continue to make the rounds, kept in business by our inexhaustible curiosity about the business of others. Religion, politics, health, money, personal relationships, and physical appearance--forget about it!" -P.M. Forni-

19. Care for Your Guests

"To entertain a guest is to make yourself responsible for his happiness." -Anthelme Brillat-Savarin-

"An essential goal of playing host is that of getting to know your guests better and strengthening your mutual bonds. To do that you only need to listen and talk from the heart." -P.M. Forni-

20. Be a Considerate Guest

"When invited to a dinner or a party, respect both times of arrival and departure. Don't overstay your welcome, but don't leave too soon. Rely on common sense and your hosts' cue. -P.M. Forni-

21. Think Twice Before Asking for Favors

"Don't ask for favors too casually or too often--recognize the amount of effort you're requesting. If possible, accomplish your task in some other way...Be clearly grateful for a favor done. Even if the task appeared easy for the person, give full credit--the person may be keeping the difficulties or unpleasantness of the effort from you." -Janet Gallant-

22. Refrain from Idle Complaints

"What concerns me is the continuous or recurring complaining that is an unwarranted spreading of misery. It is the kind that bespeaks helplessness rather than assertiveness, is more interested in assigning blame than in finding solutions, and is rooted in the feeling that life is unfair." -P.M. Forni-

23. Accept and Give Constructive Criticism

"It's almost impossible not to enjoy the sense of validation that comes with praise, but it is criticism that makes us learn what we are unable or unwilling to learn by ourselves. Whenever we turn our back on good criticism we do so at our own peril." -P.M. Forni-

24. Respect the Environment and Be Gentle to Animals

"We do not inherit the Earth from our ancestors, we borrow it from our children." -Native American saying-

25. Don't Shift Responsibility and Blame

"I simply cannot conceive of any circumstance in our daily lives when it would be appropriate or advantageous to be rude or boorish. The powerful combination of self-respect and respect for others should make it almost impossible for us to choose incivility, if we manage to remain clearheaded even in challenging situations." -P.M.Forni-

Thank you thank you Molly Jade for tipping me off to The Original Field Roast Grain Meat Vegetarian Sausages!!! My quick & easy vegan recipe repertoire has just mushroomed! If you're looking for zero fat or gluten-free--sorry, look elsewhere--but there's just 1g sat fat & 0 trans fat and the oil they use is expeller pressed. Sorry, my low-fat fans!

Never in a million years would I have found these "real food" delectable gourmet sausages--they're hidden away in the freezer case at Whole Foods. How is anyone supposed to know they exist? Just ask at customer service.

Real food-quality ingredients

Artisan-made in small batches in Seattle, Washington since 1997.

4 to a package--peel casing before cooking

About $1/a sausage

I had a non-vegetarian friend taste-test this for me and she gave it a big thumbs up!

The Field Roast Grain Meat Story

Best New Faux-Meat Product

Long ago, Field Roast founder Chef David Lee was looking for a meat substitute to use in a teriyaki wrap. He experimented with a concentrated wheat protein food called seitan (wheat gluten), whose origins date back to seventh-century China and borrowed from European cuisine, mixing the seitan with wine, mustard, garlic, herbs, vegetables, and legumes. The result formed the base for what would become an entire line of Field Roast meatless meats—now available nationwide—ranging from a variety of amazingly authentic-tasting sausages to various roasts (also available as deli slices) to veggie burgers. Field Roast has become one of the main players in meeting America's growing hunger for healthy, humane, and delicious vegetarian foods—even many nonvegetarians agree that Chef Lee's delicious meatless sausages have the "real" thing beat by a mile!

After a fantastic 4 day NYC visit with my 5 week old grandson, #1 son, #1-daughter-in-law, and #2 son from DC--I was already planning our Sunday dinner as my husband & I drove home on Sunday.

We weren't going to get home until 8:00 pm, but I had all the ingredients in the fridge for this rice salad and I knew I could whip it up within 30 minutes. Really. I've been making this dish for years & I know all the short cuts. I figured my sausage-pepper salad was history now that I've "mostly" sworn off meat. But it's back with a vengeance now that I've discovered Field Roast! Woo-Hoo!

1/3 cup Mori-Nu low-fat silken tofu (this was originally 1/2 cup of olive oil) If you don't want to add the tofu--the recipe still works out well.

NOTE: Non-tofu option. Soak 1/2 cup of raw cashews in 1/2 cup of water for 1 hour while preparing the recipe. In a high-power blender (like a VitaMix--blend the cashews, water, lemon, juice, & salt just as you would the tofu.

1. Microwave the frozen rice--or cook the real thing--making enough for 4 to 4.5 cups.2. Transfer rice to a large bowl and mix in cut up sausage, peppers, onions, basil, and parsley.3. Mix the tofu (or see above: 1/2 cup of raw cashews soaked in 1/2 cup of water), lemon juice, & salt in a blender or a Vita-Mix. Add the fresh pepper after it's mixed.4. Mix dressing into rice/pepper/sausage mixture and adjust seasonings.5. Serve at room temperature or chilled. 6. Hope you have left-overs. It makes a wonderful lunch.7. Serves 4-6

Good News for Vegetarian Grillers

HCAs, a family of mutagenic and cancer-causing compounds, are produced during the grilling of many animal products, including chicken, beef, pork, and fish. In January of 2005, the federal government officially added HCAs to its list of known carcinogens.

Plant-Based Foods Yield Negligible HCAs Since creatine, one of the ingredients for the formation of HCAs, is mostly found in muscle tissue, it is not surprising that grilled veggie burgers and other vegetarian foods contain either no HCAs or negligible levels.

Choosing plant-based foods instead of meat also lowers cancer risk in other ways. Not only are vegetables low in fat and high in fiber, they also contain many cancer-fighting substances.

Safe alternatives, which produce undetectable levels of HCAs when grilled:

Last week I finally found the fix for my vegetarian BBQ Blues! First I experimented with barbecued chicken sandwiches made in a flash. And then I discovered Smoky Portobello Sliders, better-than-real-burgers-with-grilled-onions, in the July/August issue of Vegetarian Times. Not as quick--but worth it.

The Healthy Librarian's Five-Minute Barbecued Chicken Sandwich

1 package of Trader Joe's Chicken-Less Strips. Find them in TJ's refrigerated case. Substitute a package of frozen Morning Star Farms Meal-Starters "Chicken", if you aren't near a Trader Joe's. I no longer have the box they came in, so I can't fess up to exactly what's in them--but as far as "fake food" goes, they are mostly "real" ingredients, and the taste & texture would fool most chicken-lovers. I'm not a big fan of fake meat substitutes--but for summer BBQ--I'm changing my tune.

4 whole wheat mini-buns. Once more, my new favorite is to use Trader Joe's whole wheat dinner rolls, instead of the buns. Less bun, less calories!

1. Oil or spray a grill topper & heat it up on your grill. For easy veggie grilling just go out & get a grill topper.

"With a vegetable grill topper, the size of the vegetables doesn't become a limiting factor and you don't have to worry about slices falling through the grate," recommends master vegetarian griller, Andrea Chesman.

2. Quickly grill the chicken strips until slightly browned. Don't let them dry out. Then brush with sauce. Continue grilling for a few minutes until the sauce caramelizes & the strips are nicely glazed. You could do the "saucing" in a fry pan, if you wanted, but it does need the initial grilling for the right smoky taste.

3. Toast whole wheat buns on the grill.

4. Add some extra sauce, coleslaw, avocado slices, or whatever you like on barbecue chicken sandwiches.

For the future: I plan to experiment with Trader Joe's Beef-less strips on the grill for both barbecue beef, ribs, & teriyaki flank steak substitutes--especially as salad-toppers. Chicken & beef for grilled fajitas, too.

Vegetarian Times Smoky Baby Portobello Sliders

This one takes a little more time and I've made them as mini-sliders with baby portobellos, and as full burgers with regular portobellos. The sliders take a little more fussing, but they're fun to eat--definitely company fare. No exaggeration--these burgers are fantastic--sweet & spicy & smoky & juicy & darn right sophisticated! It's hard to believe, but they're even better as leftovers--which I would never say about a hamburger.

Note: the grilled onions can be made up to 2 days ahead, and once you've made the Classic BBQ Rub, it's ready to go for the next time you make burgers.

2. Heat remaining 2 Tbs. oil in a large skillet over medium heat. Add onions and herbes de Provence, and cook 30 minutes, or until golden, stirring occasionally. Remove from heat, and season with salt and pepper, if desired.

3. Heat grill or grill topper over medium-high heat. Rub grill topper with oil, or spray well. Place mushroom stem side down on grill. Brush mushroom tops with barbecue sauce, and grill 3 or 4 minutes until soft & charred around the edges. (Larger mushrooms may take longer) Flip, and grill 3 minutes more. Divide cheese among the mushrooms, placing in center of each stem side. Grill 1 minute more, or until cheese is melted.

4. Meanwhile, warm buns on the grill.

5. Spread barbecue sauce on bottom buns, then top each with 1 mushroom, sauteed onions, and top bun.

"This basic spice blend can be added to marinades or sprinkled directly on grilled vegetables. The recipe makes enough for a number of Smoky Portobello Sliders. Store in an airtight container to use throughout the summer." VT

1/4 cup light brown sugar

1/4 cup smoked (or sweet) paprika--or go 1/2 & 1/2

3 Tbs. ground black pepper

3 Tbs. kosher or coarse sea salt

2 tsp. garlic powder

1 tsp onion powder

1 tsp celery seed

1/2 tsp. cayenne pepper

Combine all ingredients in small airtight container. Mix well to blend. Store in the refrigerator.

My Big Barbecue Brat Disappointment

Kathy over at the The Lunch Box Bunch blog raved about Tofurky's Vegan Beer Brats. "They are higher in calories, but very tasty and a nice
plump size. Uses real microbrewed Full Sail Ale in the flavoring. Grill approved. 260 calories, 13 g fat, 27 g protein." The microbrewed beer is what suckered me in.

I couldn't resist Kathy's delicious photos. Too bad the brats were such a disappointment. This was supposed to be a real treat for my husband on Father's Day. We both really really wanted to like them. Didn't happen.

Flat bland taste, an unappealing fake mealy texture, with a bit of a nutmeg in the flavor--not the kind of taste I was hoping for in a brat. Looks good, tastes--not-so-good. Actually, I did enjoy the left-over brats cut up on a salad the next day for lunch. Go figure.

July 01, 2009

A new test that evaluates cognitive ability -- and which you can give yourself -- appears to be faster and more accurate than current tests in detecting early dementia, according to British researchers.

Scroll right to the bottom of the page if you want to try out the test.

Is there anything more frightening than a diagnosis of Alzheimer's or dementia?

Dementia is far more common than we'd like it to be. It's estimated that "24 million people in the world suffer from dementia and the number will double every 20 years." Certainly, not all dementia is Alzheimer's disease. Cognitive problems plague those with stroke, Parkinson's disease, head injury, and epilepsy. And still more will suffer from milder forms of cognitive impairment.

But, as Dr. Clair Nicholl of Addenbrooke's Hospital says in an editorial accompanying Brown's BMJ article, "Without a diagnosis, patients and caregivers cannot access the services they need, so earlier diagnosis is a key component of the National Dementia Strategy in the United Kingdom. However, early diagnosis is not easy and no definitive test exists. A quick screening test is needed in primary care and general hospital practice."

Dr. Brown'snew "Test Your Memory - The TYM Test" is quick to use, examines 10 skills, and reportedly detects 93% of the cases of Alzheimer's disease. Brown says this self-administered test is a powerful and valid screening tool, more sensitive than the standard Mini-Mental State Examination (MMSE) (93% vs 52%).

Remember, this is strictly a screening tool. Further professional evaluation is always necessary, and low scores may be attributed to anxiety or dyslexia.

This test has participants write 10 answers on a double-sided card, and the tasks evaluate a range of areas--the patient's semantic knowledge--the ability to calculate--name objects--recall information. Looking at the questions it seems clear to me that the test would have to be modified (controlled) for age, ethnic, racial, & cultural biases to work in the U.S.

A sample of the questions: List 4 creatures beginning with "S". In what year did the 1st World War start?It took people who had no history of cognitive problems about five minutes to complete the test. Their average score was 47. However, people with Alzheimer's took longer to finish the test and earned an average score of 33. People with mild cognitive impairment had an average score of 45.

Certainly, longer scales and more thorough testing would be required for a firm diagnosis, but this test looks like it just might be a simple accurate sensitive tool to diagnose cognitive problems. Dr. Brown claims it is sensitive enough to distinguish between mild cognitive impairments that may likely progress to dementia within two years, from those that likely will not.

And for the best or worst part--try the test yourself. The scoring is included. Click here.**Remember this was developed in England--you might want to substitute the U.S. President for the Prime Minister--and consider the year the U.S. got involved in WWI--I'm by no means a test-maker--but those seem reasonable switches.

For more detailed scoring click here I wasn't able to access this page at the time of this writing.

And while I'm on the subject of dementia & Alzheimer's, take a look at this excellent short article from the New York Times: "Getting Insurance for One's Frailest Years", by Walecia Konrad. Nothing is more devastating to families and finances than getting good care for a family member with dementia. After reading this, my husband & I are starting to research the options.